骨科关节置换手术围手术期抗菌药物应用调查

目的：了解甘肃省中医院关节置换手术患者围手术期抗菌药物的使用情况。方法：对2010年1月至2012年12月出院的647例关节置换手术患者围手术期抗菌药物的种类、给药天数、联用情况、用药时间等情况进行统计分析。结果：调查的手术中以全髋关节置换术为主,占52.40%;有94.40%的患者在术前0.5-2小时进行预防性给药,术后抗菌药物使用时间超过48小时者占96.10%。术前预防使用的抗菌药物中,主要以一代头孢菌素类（33.40%）和β-内酰胺酶抑制剂（31.50%）为主,预防用药以单用为主,占79.80%,其次为二联用药,占18.70%。术后抗菌药物使用3-7天的最多,占88.56%。结论：关节置换手术抗菌药物预防用药存在术后用药时间偏长、联合用药的现象,还存在手术时间超过3小时及手术失血超过1 500 mL的患者术中未使用抗生素等问题,有必要加强我院外科手术预防性使用抗菌药物的管理,进一步规范抗菌药物的合理应用。

Survey of Antibacterial Drug Applied to Orthopedic Patients in Perioperative Period after Joint Replacement Surgery

Objective：To investigate the conditions of antibacterial drugs applied to the patients in periopera-tive period after joint replacement surgery in Gansu Provincial Hospital of Traditional Chinese Medicine. Methods：The kinds of antibacterial drugs, medication days, the combination, medication time and other conditions of 647 pa-tients undergoing joint replacement surgery, who were discharged from January, 2010 to December, 2012, were ana-lyzed statistically. Results：The patient were performed with total hip replacement （THR） mainly, and they occupied 52.40%; 94.40% of the patients took preventive medicine at the time of half of the hour to two hours before the surgery, the patients taking antibacterial drugs more than 48 hours after the surgery reached 96.10%. Antibacterial drugs taken before the surgery for the prevention were cephalosporins generation one （33.40%） andβ-lactamase in-hibitor （31.50%） mainly, preventive medication was using single drug usually, and it occupied 79.80%, the next was the combination of two drugs and it reached 18.70%. The medication time of antibacterial drugs after the surgery was from three to seven days mostly and it occupied 88.56%. Conclusion： Preventive medication of antibacterial drugs for the patients with joint replacement surgery presents the problems of medication time too long after the surgery, the combination of drugs, the patients with surgical time more than three hours and bleeding volume over 1 500 mL didn＇t use antibacterial drugs, it is necessary to enhance antibacterial drugs management in preventive medi-cation of surgery in our hospital, therefore to regulate rational use of antibacterial drugs.